Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | C39371 | CA |
NPI | 1013935444 |
---|---|
Provider Name | Dr. Lung Chang |
First Address | Alhambra, CA 91801 |
Second Address | Alhambra, CA 91801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C393711 | (05) | CA |
A88098 | (02) |